Use of the life story in the institutional care of people with dementia:: a review of intervention studies

This paper reports a systematic review of 28 evaluations of interventions that aimed to describe the benefits of the use of the life story for nursing-home residents with dementia, particularly with reference to their sense of identity. The 28 studies were published during 1990-2003. The review focuses on the methodology of the evaluations, and on how the studies contributed to our understanding of the value of using a resident's life story in care interactions. The studies were divided into three groups by the purpose of the intervention: to raise self-esteem and self-integration; to improve life quality; and to change behaviour. The features of the interventions that were associated with enhanced sense of identity were a thorough and encompassing treatment of the individual's life story, the translation of the life story into care interactions, and active encouragement of the residents' initiatives. Only one intervention had all of these features. The diverse aims and forms of the interventions were mirrored by the diverse methodologies of the evaluation studies. Recently the trend has been towards more rigorous designs that measure a few precisely-defined quantitative outcomes but at the cost of a narrower appreciation of the impacts. Given that there is still a great deal to learn about how best to deliver sensitive, individualised and effective support and care to people with dementia, it is argued that qualitative assessments have been too hastily discontinued.